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提示训练对帕金森病患者运动诱发电位和皮质静息期的影响。

Effect of cued training on motor evoked potential and cortical silent period in people with Parkinson's disease.

机构信息

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.

出版信息

Clin Neurophysiol. 2013 Mar;124(3):545-50. doi: 10.1016/j.clinph.2012.08.017. Epub 2012 Sep 23.

Abstract

OBJECTIVE

To examine whether training under visual cues could enhance motor cortical excitability and intracortical inhibition in individuals with Parkinson's disease (PD).

METHODS

This was a single blinded cross-over study. Eight individuals with PD received two sessions of 30-min pinch-grip training with and without visual cues. The visual cue was given in form of an arrow that indicated the pre-set force level on a computer screen. Outcome measures consisted of peak motor evoked potential (MEP) and cortical silent period (CSP) of the first dorsal interosseus as well as behavioural tests including Purdue pegboard test, tapping speed in 30s, and the maximum pinch grip force exerted by the thumb and index finger.

RESULTS

After cued training, there were significant increases in the peak MEP, CSP duration and tapping speed (all p<0.05). In contrast, there was no change in all outcome measures after training under the non-cued condition.

CONCLUSIONS

Thirty minutes of pinch-grip training with visual cues could enhance motor cortical excitability and intracortical inhibition in individuals with PD.

SIGNIFICANCE

The findings on the neurophysiological changes after cued-training may inform further clinical application of visual cues to maximize motor improvement and corticomotor plasticity in people with PD.

摘要

目的

研究视觉线索训练是否可以增强帕金森病(PD)患者运动皮层兴奋性和皮质内抑制。

方法

这是一项单盲交叉研究。8 名 PD 患者接受了两次 30 分钟的夹捏训练,一次有视觉线索,一次没有。视觉线索以箭头的形式出现在电脑屏幕上,指示预设的力水平。主要结果测量包括第一背侧骨间肌的最大运动诱发电位(MEP)和皮质静息期(CSP),以及行为学测试,包括 Purdue 钉板测试、30 秒内的敲击速度和拇指与食指的最大夹捏力。

结果

在有线索训练后,MEP 峰值、CSP 持续时间和敲击速度均显著增加(均 p<0.05)。相比之下,在没有线索的情况下进行训练后,所有结果测量均无变化。

结论

30 分钟的夹捏训练加视觉线索可以增强 PD 患者的运动皮层兴奋性和皮质内抑制。

意义

关于有线索训练后的神经生理变化的发现可能为进一步将视觉线索应用于临床,以最大限度地提高 PD 患者的运动改善和皮质运动可塑性提供信息。

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